by Drew PinskyRegan Books, 2003Review by James E. de Jarnette, Ph.D. on Jan 5th 2005

Hilariously funny and mixed with
pathos and compassion from the start to the finish, Crackedby
Drew Pinsky is informative and very familiar to of those professionals who have
ever dealt with in-patient alcohol and drug abuse patients.

How often have I heard patients say, "All I need to do is get
sober; then I can control my life."
There is something intrinsically wrong with this statement when this
same patient has used it on three other admissions to detox and treatment.

Katherine
is a perfect example of a user who thinks all she needs to do is get off the
drugs. Getting off is the necessary
first step, of course. It's dramatic
and interesting. But it's only the
first step in treating the disease.
It's like getting into position to do the work. Katherine is falling apart all over the place. Having hid the truth about what she'd been
using –a common tactic among addicts--now, in addition to her opiate withdrawal
she's dealing with a Valium habit, too.
She's a mess in every way. She
discovered that there aren't any quick fixes.
How can there be, when the patient has used drugs to regulate emotions
she can't manage normally? Generally, these
over-whelming emotions are related to childhood traumas--pain, abuse neglect,
abandonment, and overall feelings of powerlessness. There aren't any simple eight-hour cures for that. (page 17)

In the afore-quoted
monologue by Pinsky, the foundation for the remainder of the book is laid
bare. Alcohol and Drug Abuse is just
the tip of an iceberg that goes down many fathoms into a cold sea of past
wreckage. He continues by putting this
in a much broader psychosocial perspective.

I
have plenty of reasons to call the culture up on charges. Katherine, Amber, Mitch, and hundreds more
just like them. The culture is like a
living, breathing beast that feeds its own need to exist and grow at the
expense of the individual. Our world is
full of people with narcissistic problems who look to escape those feelings and
be gratified--and the culture steps right up to meet those needs. Many of those contributing to the culture
are sick themselves. It doesn't take a
shrink to count the number of celebrities who end up in rehab, getting into
fights, or posing for mug shots. The
media has become an instant-response machine, ratcheting our tolerance ever
upward in cycles of arousal and gratification.
All of this can be arresting, fun, sexy, most of all, it sells. But it doesn't heal. (page 19)

Pinsky
talks about an issue that many people not adequately trained in the behavioral
sciences, and some who are, just don't talk about. What do you do with the family, significant others, and friends
of the patient receiving treatment?

"I
know it's tough to understand, but what you need to do is let us take care of
her. These nurses know what they are
doing. They've done thousands of
detoxes…"

"If
she's going to have a successful recovery, you're going to have to change as
well. I know you're eager to get her
back the way she was before the drug use really took off, but that is simply
not possible. She has some real serious
problems here, and she's going to have to work very hard at growing and
changing."

Hoping
to get through to Jack enough that he'll get off her back and maybe even start
taking a look at his own problems, I take a stab at educating him. "I think a simple way to think of
relationships is like a lock and key.
Emotionally, when tow people come together they fit together in much the
same way the jagged edge of a key fits with the tumblers of a lock. But any traumatic emotional change can
change the way those tumblers are shaped."

"That's
what happens when a drug addict starts coming to terms with her problems--and
it can be very scary to be involved with someone who's going through those
emotional changes. It can be very
uncomfortable when you no longer fit the way you always did. It can feel like you are losing your
partner." (page 108)

I
really enjoyed this book on so many levels.
I treat a large number of addicts and substance abusers. The information contained in this book is
very good for professionals as well as substance abusers/addicts. I plan on recommending it to my patients and
I recommend it to you.

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